NEET-PG 2015 - Obstetrics and Gynecology Practice Questions

Q: Which is false about stress urinary incontinence?

More common in men. ***More common in men*** - **Stress urinary incontinence (SUI)** is significantly more prevalent in **women** due to anatomical differences and factors like childbirth. - While it can occur in men, especially after prostate surgery, the overall incidence is higher in females. *It is due to weakening of pelvic floor muscles* - Weakening of the **pelvic floor muscles** is a primary cause of SUI, leading to insufficient support for the urethra and bladder neck. - This weakness compromises the ability to maintain urethral closure pressure during activity. *Prostate surgery may be a cause* - **Radical prostatectomy** for prostate cancer is a common cause of SUI in men, as it can damage the urethral sphincter. - Damage to the internal or external urethral sphincter during surgery impairs the ability to control urine flow. *It occurs during increased abdominal pressure* - SUI characteristically involves involuntary urine leakage during activities that increase **intra-abdominal pressure**, such as coughing, sneezing, laughing, or exercising. - This increased pressure overcomes the weakened urethral resistance, leading to urine loss.

Q: Which of the following describes the points marked in the diagram of pelvic measurements?

Diagonal conjugate. ***Diagonal conjugate*** - The image depicts a **bimanual examination** where one hand is inserted vaginally to measure the distance from the **lower border of the pubic symphysis** to the **sacral promontory**. - This measurement directly corresponds to the **diagonal conjugate**, which is a clinically estimated measurement of the pelvic inlet. *Obstetric conjugate measurement* - The **obstetric conjugate** is the smallest anteroposterior diameter through which the fetal head must pass. - It extends from the **middle of the sacral promontory** to the **innermost aspect of the pubic symphysis** and cannot be measured directly by clinical examination. *True conjugate measurement* - The **true conjugate**, also known as the anatomical conjugate, extends from the **sacral promontory** to the **upper border of the pubic symphysis**. - Like the obstetric conjugate, it is not directly palpable and must be estimated from the diagonal conjugate (true conjugate = diagonal conjugate - 1.5 to 2 cm). *Oblique conjugate measurement* - The **oblique conjugate** measures the distance between the sacroiliac joint on one side to the iliopectineal eminence on the opposite side. - This measurement is not typically assessed during a routine pelvic examination as depicted and is more relevant for identifying asymmetric pelvic deformities.

Q: Which of the following is not considered an absolute contraindication for the use of an Intra Uterine Contraceptive Device (IUD)?

Uterine malformation. ***Uterine malformation*** - While a uterine malformation can make IUD insertion more difficult or reduce its effectiveness, it is often considered a **relative contraindication**, depending on the specific anomaly and the patient's desire for contraception. - In certain cases, an IUD might still be a viable option, but it requires careful consideration and specialized insertion techniques. *Pregnancy* - The presence of an existing pregnancy is an **absolute contraindication** for IUD insertion, as it can lead to complications such as miscarriage or ectopic pregnancy. - An IUD is a contraceptive device, and inserting it when a woman is already pregnant directly contradicts its purpose and poses significant risks. *Undiagnosed vaginal bleeding* - This is an **absolute contraindication** because it could be a symptom of a serious underlying condition, such as cervical cancer, endometrial cancer, or ectopic pregnancy. - Inserting an IUD before diagnosing the cause of the bleeding could delay treatment of a potentially life-threatening condition and exacerbate the bleeding. *Pelvic inflammatory disease* - Current or recent (within the last 3 months) **pelvic inflammatory disease (PID)** is an **absolute contraindication** due to the increased risk of worsening infection. - IUD insertion can introduce bacteria from the vagina into the uterus, potentially exacerbating an existing infection or causing a new one.

Q: Le Fort's operation is done in

Elderly menopausal patients with advanced prolapse. ***Elderly menopausal patients with advanced prolapse*** - Le Fort's operation is a **colpocleisis** procedure, which permanently closes the vagina, making it suitable for elderly patients who are no longer sexually active. - It is often reserved for those with **advanced uterine or vaginal prolapse** who are not candidates for more extensive surgeries due to comorbidities. *Women over 40 years, those who have completed their families* - While these patients may have completed their families, Le Fort's operation is a **definitive and irreversible procedure** that is typically reserved for those who are also postmenopausal and have no desire for future sexual activity. - Other less invasive or reconstructive options might be considered for women over 40 who still maintain sexual activity. *Women under 40 years who are desirous of retaining their menstrual and reproduction function* - Le Fort's operation involves **closure of the vagina**, which makes it impossible to retain menstrual or reproductive function. - Younger women would typically be offered **uterine-sparing procedures** or reconstructive surgeries to preserve these functions. *Young woman suffering from second or third degree prolapse* - For young women, even with significant prolapse, the primary goal is often to **preserve fertility, menstruation, and sexual function**. - Le Fort's operation would be contraindicated because it involves **vaginal obliteration**, making it unsuitable for a young woman.

Question 1

In which part of the fallopian tube is ectopic pregnancy most likely to survive longer?

Accepted Answer

Interstitial

Answer

Isthmus

Answer

Ampulla

Answer

Cornua

Question 2

Which is false about stress urinary incontinence?

Accepted Answer

More common in men

Answer

It is due to weakening of pelvic floor muscles

Answer

Prostate surgery may be a cause

Answer

It occurs during increased abdominal pressure

Question 3

Which of the following describes the points marked in the diagram of pelvic measurements?

Accepted Answer

Diagonal conjugate

Answer

Obstetric conjugate measurement

Answer

True conjugate measurement

Answer

Oblique conjugate measurement

Question 4

Which of the following is not considered an absolute contraindication for the use of an Intra Uterine Contraceptive Device (IUD)?

Accepted Answer

Uterine malformation

Answer

Undiagnosed vaginal bleeding

Answer

Pregnancy

Answer

Pelvic inflammatory disease

Question 5

Le Fort's operation is done in

Accepted Answer

Elderly menopausal patients with advanced prolapse

Answer

Women over 40 years, those who have completed their families

Answer

Women under 40 years who are desirous of retaining their menstrual and reproduction function

Answer

Young woman suffering from second or third degree prolapse

NEET-PG 2015 — Obstetrics and Gynecology